A Better Way to Manage Pain

Seriously ill people need special care. Palliative medicine can help

For Gail Cooney, 59, palliative care means yoga, acupuncture and counseling to help her through aggressive chemotherapy for her ovarian cancer. For 93-year-old Jack Hilder, it means home visits that help him keep living independently in a Chicago suburb despite a stroke that has limited his mobility.

A palliative team can help a patient manage pain and make the most of life with a serious illness. — Illustration by: Alex Nabaum

Palliative care can help ease the burdens of complex illnesses like cancer, heart disease and diabetes, but confusion and fear keep many from getting this service. Like hospice care, with which it is often confused, palliative care focuses on helping patients with their pain and symptoms, and offering counseling and other services.

But if hospice care is about a good death, palliative care is about making the most of life with a serious illness, whether the disease is terminal or not.

"Doctors think that you only call palliative care when your patient is about to die," says Diane Meier, director of the Center to Advance Palliative Care in New York. "Patients don't know what it is and don't demand it. They don't realize they have a right to care focused on improving function and quality of life."

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Cooney, of West Palm Beach, Fla., recently finished six months of chemotherapy. "I'm still working, and I give a lot of credit for that to a strong palliative care program," she says.

Palliative care takes a team approach, providing a doctor, nurse, social worker and chaplain working together to go beyond strictly medical issues to address all of a patient's needs. That could include managing pain and nausea associated with a disease as well as counseling or help in navigating the health care system. About 58 percent of U.S. hospitals provide palliative care, according to the Center to Advance Palliative Care, a number that has more than doubled since 2000.

Palliative care is a relatively new specialty, but studies already have found it makes a difference. For example, lung cancer patients who received early palliative care, along with standard treatment, on average lived almost three months longer than those who didn't, according to a 2010 study in the New England Journal of Medicine. This may be because people whose pain and symptoms are well managed can tolerate more aggressive or longer treatment, experts say. The patients in the study also experienced less depression and better quality of life.